Carrying and giving birth to a child affects the body of women serious workload, on physical level. Under the influence of hormones, cartilage tissue softens, bones separate, ligaments and muscles stretch. This is necessary so that the baby's passage through birth canal it was painless. Reversal changes and restoration of the body can be delayed and occur with complications. Complaints from mothers that the pubic bone hurts after childbirth are common. In addition to severe pain, pathological divergence of the symphysis pubis is accompanied by changes in gait and generally spoils a woman’s quality of life.

The pubic symphysis is a type of semi-movable skeletal joint located in one of the three pelvic bones - the pubis. In medicine it is called the pubic or pubic symphysis. Unlike joints, symphyses do not calcify over time, do not lose their cartilage layer, and have a cavity inside. For example, intervertebral discs are also symphyses.

During pregnancy and childbirth, transformation of the symphysis pubis occurs, often accompanied by moderate pain in the pubis. The gap between the branches of the pubic bone increases, on average, by 5-6, sometimes by 10 mm from the initial values. This is a physiological phenomenon.

Normally, in the postpartum period, the discrepancy of the pelvic bones is eliminated, the width of the cavity becomes denser and decreases. But, with favorable factors, changes in the structure of the joint sometimes go beyond the normal. In such cases, they talk about symphysiopathy, which means pathology of the pubic symphysis, in which the pubic bone hurts greatly.

Sometimes the term symphysiolysis or symphysiolysis is used synonymously with symphysiopathy. In obstetrics it is known as a syndrome that includes three stages. The first is pain in the pubis, the second is divergence of the symphysis pubis varying degrees(symphysiolysis itself), and the third is rupture of the symphysis.

In practice, the word symphysitis is used to denote a collective diagnosis of excessive and painful divergence of the pubic bone. But in essence, symphysitis is translated as inflammation bone tissue joints, manifested by similar symptoms, but with differences in diagnosis.

Reasons

There is no consensus on why pathology occurs. The trigger for a situation where the pubis hurts after childbirth is a number of factors. This is also anatomical narrow pelvis, and a large fetus, and multiple pregnancy. In combination with rapid, violent labor or the use of obstetric forceps. This leads to the fact that the pelvic bones do not return to their previous state in a timely manner, and sometimes become even more damaged.

These factors and mechanical injuries do not always cause complications in the form of symphysiopathy or rupture of the articulation. Bosom in healthy body Can withstand loads up to 200 kg. But the dispositional moments lead to the fact that during the birth process it is overstretched and damaged.

Why does the pubic bone hurt after childbirth:

1. acute deficiency of vitamins and minerals leads to pathological “weakness” of the skeleton;
2. Excessive production of the hormone relaxin contributes to excessive relaxation of the tissues of the pubic joint.

The main role in the development of symphysiopathy belongs to vitamin D deficiency and failure of calcium-phosphorus metabolism. This happens in the background concomitant diseases. For example, when diabetes mellitus, renal failure, problems in the gastrointestinal tract and often with an unbalanced diet of pregnant women.

As a result, weak mineralization of the woman’s bone tissue occurs. During pregnancy, in order to meet the fetal needs for calcium, it is “redistributed” to the detriment of the mother’s body. In this case, the pathology manifests itself earlier, pain in the pubis occurs even before childbirth.

Second version - hormonal imbalance. Relaxin is responsible for the relaxation of bone tissue and the physiological divergence of the symphysis pubis. Excessive production of the hormone leads to a pathological increase in the symphysis gap and discomfort in the pubic area.

Symptoms and complications

Typically, signs of pathology appear during pregnancy. At the end of the second and third trimester of pregnancy, the pubic bone begins to ache before childbirth, and the sensations intensify. Articulation discrepancy can be suspected if there are concomitant problems with teeth, hair loss, or the appearance of convulsive twitching of the calf muscle.

It is not uncommon for the first symptoms of pubic bone dehiscence to occur only after the birth of the child. Due to constant tone Abdominal muscles holding the growing uterus, a kind of fastening of the symphysis occurs. After childbirth, the flabby abdominal muscles no longer hold back the joint, and the gap appears, accompanied by pain.

The severity of symptoms depends on how much the bones have separated. In addition to pain in the pubic bones, the woman complains of pain in the groin, lower abdomen, lower back and pelvis that occurs at night or after physical activity. Discomfort increases when walking, changing position, moving your leg to the side, turning in bed or rising from a chair.

In addition to pain, the pathology provokes poor posture. A pronounced divergence of the articulation contributes to the appearance of a waddling gait, called a “duckling”, up to total loss ability to move. Sometimes upon palpation you can hear a cracking or clicking sound coming from the pubis, while the pubic bone is painful.

A dangerous type of injury is rupture of the symphysis during childbirth. The condition is rare and is characterized by a violation of the integrity of tissues and ligaments. Occurs when pathological expansion pubic fissure of more than 20 mm and lack of adequate labor management tactics.

A ruptured joint damages the bladder and urethra. Often the pubis after childbirth turns blue and swells, a hematoma appears in its area and an inflammatory process occurs - symphysitis.

Diagnostics

Discrepancies of the pubic bone during childbirth are determined based on the woman’s complaints of characteristic pain. At gynecological examination the doctor can literally feel the gap in the womb and feel its asymmetry.

The diagnosis is confirmed after X-ray, ultrasound or MRI of the symphysis, where the discrepancy of the symphysis pubis is clearly determined by more than 0.8-1.0 cm. In this case, destructive changes in the pelvic bones are not detected. A rupture of the symphysis is indicated when an x-ray shows a gap in the pubis 7-8 cm wide and there is a horizontal displacement of the bones.

Pathological discrepancy of the symphysis pubis is divided into three stages:

• I – increase in the symphysis gap by 5-9 mm exceeding the physiological expansion during pregnancy;
• II – by 10-20 mm;
• III – more than 20 mm.

Regardless of the results additional examinations, a fundamental factor for medical report constitutes the well-being of the mother in labor. Thus, a discrepancy of 1 cm in one woman indicates symphysiopathy and becomes a reason for a caesarean section, while in another it does not cause any discomfort.

When visualizing the destruction of bone tissue, that is, with porosity, friability, the question arises about the addition of inflammation and then the diagnosis of symphysitis is made. In this case, usually simultaneously with the appearance of pain, the woman notes that her pubis has become larger after childbirth and has turned red. This occurs due to swelling of the soft tissues. During the inflammatory process in the womb, an increase in body temperature is observed.

Clinical blood tests show a decrease in the level of calcium and magnesium, while urine tests, on the contrary, show a slight increase. With symphysitis, unlike symphysiopathy, leukocytes are also found in the urine. Differential diagnosis carried out with radiculitis, inflammation sciatic nerve, hernias, pelvic vein thrombosis.

Treatment

The divergence of the symphysis can be corrected without surgical intervention. Severe ruptures of the symphysis pubis do not go away on their own; surgery is required using lavsan, wire sutures, knitting needles, and titanium structures. Recovery period takes 3-4 months after surgical treatment.

The existing inflammatory process (symphysitis) is controlled by taking antibiotics to eliminate the source of infection. At the same time, therapy is carried out aimed at eliminating the causes that caused the discrepancy of the pubic bones. Prescribed calcium and magnesium supplements, vitamins D, group B, fish oil. Conducted ultraviolet irradiation womb area.

What to do if your pubic bone hurts after childbirth:

• consult a doctor and do not self-medicate;
• take medications and perform physical procedures and exercises for the pelvic muscles prescribed by a doctor;
• enrich the diet with foods containing calcium, magnesium and other elements;
• limit or eliminate physical activity;
• provide support for the pelvic bones with a bandage or corset;
• For pain relief, use special gels, ointments, creams or tablets.

Self-medication for pubic pain is extremely contraindicated. Only a doctor can accurately determine the width of the articulation divergence and, therefore, select effective therapy. If at the first stage of symphysiopathy it is enough to limit activity and take vitamins, then for the second and third stages more serious measures are necessary. Bed rest lasts at least 3-6 weeks, and tight or postpartum swaddling is often used. The goal of the measures is to achieve maximum approximation of the edges of the symphysis.

The lack of adequate help leads to the fact that pubic pain does not go away for more than 6 months, sometimes even several years. This occurs as a result of improper fusion of damaged tissues, their replacement with scars and development chronic pathology. Prevention postpartum complications symphysis consists of obligatory healthy diet, taking special vitamin and mineral complexes and providing physical activity even at the stage of pregnancy.

The birth of a baby is one of the most happy events in a woman's life. It is also the most painful. After all, the process of childbirth is not always calm and quick. It involves complex mechanisms the work of the reproductive system, the components of which are the divergence of the pelvic bones. The woman’s body prepares for this process in advance, which is accompanied by significant discomfort and pain. When, after childbirth, do the pelvic bones return to their proper position? natural position? What are the features of this process?

About the timing of the convergence of the pelvic bones

The postpartum period is a time no less important than pregnancy itself. This is why many experts call it the tenth month. For nine months female body actively prepared for the birth of the baby, adjusted to his needs, and endured discomfort. Therefore, it is not surprising that the recovery period after childbirth cannot be quick. Only to recover reproductive system, it takes at least 6-8 weeks, after which the woman needs to see a gynecologist.

Major changes to female body When carrying a child, they occur due to the action of hormones. During pregnancy, they are actively produced, which is necessary for the healthy development of the fetus, preparing ligaments and bones for the upcoming birth. After the baby appears, the woman’s body again undergoes hormonal changes. Those hormones that were responsible for the development of the child fade into the background; the hormone prolactin, necessary for the production of breast milk. The process of restoration of a woman's body after childbirth is called involution. It also provides for the convergence of the pelvic bones.

What happened to them before the baby was born? Obstetricians-gynecologists state that the divergence of the pelvic bones occurs immediately before childbirth. Essentially this is softening cartilage tissue in the area of ​​the pubic symphysis, the divergence of the bones does not go beyond one and a half to two centimeters. After childbirth, there cannot be a lightning-fast return to their original state. Even if the birth was easy and quick, the bones are still long time will return to their natural position. Often this takes all postpartum period, that is, 6-8 weeks.

About gymnastics after childbirth

Experts recommend that new mothers do not delay in completing special exercises postpartum gymnastics. As soon as your health allows, you need to start. The main task of such gymnastics is to prevent negative consequences birth in the pelvic area, for example, urinary incontinence or symphysitis, uterine prolapse.

After the birth of a child, the pelvic bones return to their place after some time, but some mothers are sure that the volume of their hips increases during childbirth, but this is not so.

Thanks to restorative gymnastics, muscles are strengthened pelvic floor, the contractile activity of the uterus improves, and it returns to its original size. So, you should start doing these exercises:

1. Abdominal retraction. You need to lie on your back, bend your knees, and press your feet to the floor. Your palms should be on your stomach. It must be pulled in very strongly as you exhale and hold this position, first for 3-4 seconds, then 6-10. The exercise is repeated after a deep and slow breath.
2. Bridge. Starting position bodies the same. After exhaling, you need to raise your pelvis, tighten your buttocks and pull in your stomach. At the same time, the head is raised and the chin is pressed to the chest. This difficult exercise, the number of repetitions must be increased gradually.
3. Raising your legs. Lying on your back with your legs straight, you need to slowly lift each of them up in turn. In this case, you need to pull the sock towards you. Exercises must be performed at a slow pace.
4. Cat. The exercise is performed from a position on all fours. You need to bend your back and round it with a wheel, while drawing in your stomach. The exercise tightens the muscles of the abs, back, and buttocks.
5. Squats. Performed slowly from a standing position. You need to squat so that your hips form a right angle with the floor. At the same time, straight arms are extended forward. At the end of the execution, you can spring on your bent legs, increasing the static load and straining your abs.

So, performing postpartum gymnastics will help the woman regain her shape and the pelvic bones will quickly return to their original position.

Orthopedic traumatologist, first category surgeon, Research Institute, 2009

Pregnancy is always a huge burden on a woman’s body. It especially increases in the third trimester, when the baby grows and puts pressure on almost all internal organs. However, childbirth can also be a serious challenge.

According to statistics, more than half of new mothers complain that their pelvic bones hurt after childbirth. This syndrome may indicate serious problems in a woman’s body, and therefore there is no point in delaying a visit to the doctor. Such issues are dealt with by a specialist - a vertebrologist, who will not ignore any pain in the hip joint after childbirth, will prescribe a serious examination, and after receiving its results will give recommendations for treatment.

Disappointing statistics indicate that pelvic bones hurt after childbirth not only in women predisposed to diseases of the pelvis and spine. Even quite healthy young ladies who lead a passive lifestyle, move little, eat poorly and work hard sedentary work, may complain of hip pain after childbirth. Lack of movement significantly weakens the body of the expectant mother, this applies to both the pelvic bones and muscles. After delivery naturally such women may complain about unpleasant symptoms, including on:

• Pulling and dull pain, which can be constant and worsen during movements or even during sleep;
• Feeling of tightness in the muscles;
• Limited movement;
• Muscle spasm that does not go away for a long time.

Immediately after appearance specified symptoms you should consult a doctor. He will conduct an examination, prescribe a diagnosis and find the root cause painful sensations.

Features and needs of diagnostics

Pelvic pain after childbirth is a condition that, in pathology, almost never goes away on its own. Over time discomfort can only increase, and therefore cannot be delayed; you should immediately consult a doctor. The doctor will decide what kind of research will be needed to identify the cause of pelvic pain after childbirth. Among the methods used:

After carrying out the necessary examination, a diagnosis can be made and the cause of the pain that occurs can be established. The patient may be diagnosed with symphysitis, the severity of which will depend on the distance between the pelvic bones. There are several stages of the disease: I – up to 1 cm, II – up to 1.99 cm, III – 2.0 cm or more. If the third stage is detected, the doctor may make another diagnosis - “rupture of the symphysis pubis.”

Causes of pain syndrome

If after childbirth your leg hurts in the hip and pelvic area, an examination will be required. It can reveal displacement of the pelvic bones during childbirth. In some cases, the tailbone and pelvic bones may also become displaced. This is necessary to free the fetus to pass through the birth canal. Nature intended for this process to be virtually painless, since the woman’s body prepares for this for a long time. And while the woman may not notice the displacement itself, the process of return is quite noticeable, and therefore can bring a lot of suffering. Often young mothers complain that their hips hurt after childbirth. This may indicate that:

• There is a lack of calcium in the body - during gestation and during delivery, calcium is simply washed out of the body, and therefore the body lacks resources, which is indicated by pain syndromes.
• Softening of the tissues has occurred - this is a natural process that is caused by an increase in a certain hormone that is secreted by the body to calm the woman in labor. Since the tissues cannot perform the functions assigned to them, this leads to pain.
• Sprained ligaments and muscles are a condition that can also cause discomfort.
• Birth trauma is what most often explains why it hurts hip joint after childbirth. Dislocation, bone fracture, tissue rupture - all this can cause severe pain. Failure to see a doctor in a timely manner can lead to bones not healing properly. And this will already entail a change in gait.

The role of calcium in the mother's condition

Already at 30–34 weeks, you can notice that the pregnant woman begins to involuntarily tilt her body back, trying to shift her weight. Nature has also provided something else - a change in gait to a “duck” one, when a woman shifts from one foot to the other. But by this point future mommy He already has time to get used to the unpleasant stretching in the lumbar region, even to the pain. They can be caused by insufficient calcium. This causes the development of symphysiopathy, which is why the doctor observing the pregnant woman necessarily prescribes calcium.

Medicines strengthen bones and also reduce pain. However, you should not be overzealous in taking it - the dosage is strictly observed to avoid negative consequences, which include the formation of kidney stones. The correct approach to solving this problem eliminates pain after childbirth.

Symphysis

If the pelvis hurts after childbirth, the cause may be a change in the structure of soft tissues - dense cartilage and symphysis, located in the area of ​​the pubis and pelvic bone. Disjunction of bone tissue after childbirth is no longer uncommon, and this condition can lead to sharp and severe pain, which often does not go away, but only increases. The painful condition can be so severe that it will be difficult for a woman to walk or stand normally.

Treatment of symphysis

What to do if your pelvis hurts after childbirth? Contact a verterbrologist or another doctor who will examine the patient and take rational decision about the need for treatment. Sometimes the body copes on its own, but this is in the case of minimal damage. If the pain continues for a long time after childbirth, serious treatment will be required. The doctor decides whether it is necessary:

Quite often, doctors advise combining bed rest with exercise. You should not select exercises yourself; an osteopath should work with the patient. He also assesses the condition and makes a decision about the possibility/impossibility of performing a group of exercises.

Preventive measures

To prevent injury during childbirth, as well as the development pathological conditions, follows:

Sometimes after childbirth there are complaints of pain or unpleasant “crunching” sensations in the symphysis pubis, which intensify when changing position or walking up the stairs. A diagnosis is made: symphysitis. As a rule, a woman associates the resulting pathology with the birth. Is this fair?

A little anatomy to find out Why do my pelvic bones hurt after childbirth??
During childbirth, the fetus passes through the woman’s bony pelvis, which is formed from the sides by two pelvic bones (fused pubis, ischium and ilium), and from the back by the sacrum. Both pelvic bones are connected in front by the pubic joint - the symphysis, and in the back - by two sacroiliac joints.
Pubic symphysis - pubic fusion of both pubic bones pelvis through a fibrocartilaginous disc, in the center of which there is an articular cavity in the form of a slit, filled joint fluid. Front and back, above and below, the symphysis is strengthened by ligaments that give strength to this joint. The pubic symphysis is a semi-joint, i.e. has an extremely limited range of movement. Normally, the width of the symphysis (the distance between the pubic bones) can be up to 1 cm.
In front of the pubic symphysis is the pubis with its fatty lining and the ligament that elevates the clitoris. Nerves and blood vessels pass below the symphysis. Behind the pubic symphysis are the urethra and bladder. Symphysitis- this is the general name for changes and damage to the symphysis pubis, which hides up to 16 components: loosening, softening, edematous impregnation, stretching, expansion, divergence, rupture, inflammatory process, special shape hypovitaminosis, symphysiopathy, symphysitis itself, etc. Most often, these changes occur and manifest themselves during pregnancy, childbirth and the postpartum period. In this article we'll talk about the consequences that they can lead to. Divergence of the symphysis pubis.
It arises as a result of events physiological changes as an adaptive process to facilitate childbirth; those. these are normal changes.
At physiological pregnancy the ovaries and placenta secrete a substance called relaxin, which has a specific relaxing effect. Under the combined action of relaxin and female sex hormones, articular cartilage and ligaments swell, loosen, and additional fluid-filled gaps appear in the joints, resulting in increased mobility in the pelvic joints and an increase in the distance between the bones that form each joint.
These changes are especially pronounced in the symphysis pubis, there is an increase in blood supply, swelling and loosening of everything ligamentous apparatus. The width of the pubic articulation increases by 5-6 mm, small movements (up to 10 mm) of the articular ends of the pubic bones up and down are possible, like the keys of a piano. The width of the pubic joint reaches 1.5 cm, the divergence of the sacroiliac joint increases to a lesser extent.
In the postpartum period, all these changes are gradually eliminated - the cartilage in the joints becomes denser, the ligaments acquire their former elasticity and density, and the width of the joint space decreases. Symphysiopathy. This is the name for excessive relaxation of the symphysis pubis as a manifestation of toxicosis in pregnant women with a predominant lesion of the osteoarticular system of the woman’s body. For some women these changes in the structure of the joints go beyond physiological processes, acquire pathological character and lead to excessive divergence of the pelvic joints. Symphysiopathy is characterized by the appearance of complaints and symptoms in the presence of discrepancies in the symphysis pubis. There are three degrees of divergence of the symphysis (above the physiological discrepancy of 5-6 mm):
I degree - discrepancy by 5-9 mm;
II degree - by 10-20 mm;
III degree - more than 20 mm.
A leading role in the development of symphysiopathy is played by disturbances in phosphorus-calcium metabolism and a lack of vitamin D. Calcium is the main structural component of skeletal bones and teeth. The metabolism of calcium and phosphorus is regulated mainly by the hormone pair thyroid gland, calcitonin - a thyroid hormone - and vitamin D, depends on the quality of food, the ratio of calcium, phosphorus and magnesium in it. When the phosphorus-calcium balance is disturbed in the direction of decreasing calcium, these elements come to the fetus from the “reserves” of the mother’s body - bones and teeth.
With a lack of vitamin D, bone mineralization is impaired due to impaired absorption of calcium and phosphorus from the intestine, as well as their mobilization from bone tissue. A decrease in blood calcium levels may also occur with concomitant pathology: diseases gastrointestinal tract, chronic enteritis, dysfunction of the parathyroid gland, renal failure, diabetes mellitus, as well as diet With insufficient content calcium, vomiting of pregnancy and other conditions. Against such a painful background, pregnancy and breastfeeding can aggravate calcium deficiency.
As a rule, symphysiopathy manifests itself long before childbirth. Against the background of calcium starvation, tooth decay, brittle nails, general fatigue, paresthesia (the appearance of a tingling sensation and changes in skin sensitivity), twitching and contraction of individual muscles are characteristic, especially night cramps in the calf muscles. With minor discrepancies of the symphysis, the appearance of “flying” pain in the pelvic bones and lower back is regarded as radiculitis, osteochondrosis, or threat of miscarriage. In the second and third trimester of pregnancy, symphysiopathy is characterized by pain and discomfort in the pelvic bones when walking and standing.
The disease is not uncommon. Symphysiopathy may not make itself felt before childbirth and may be hidden. In the second half of pregnancy, the pubic bone ratio is constrained by the tension of the abdominal muscles due to the enlargement of the uterus. Immediately after childbirth, flabbiness of the abdominal muscles occurs and the discrepancy of the pubic bones can increase to 20 mm or more. For symphysis pubis discrepancy II and especially III degree during pregnancy and childbirth, diagnosis is not difficult: a change in the nature of pain in the symphysis area occurs, which intensifies when turning in bed, with active movement of the legs, often the woman cannot walk. In bed, the patient takes a certain position - the “frog pose”: she lies on her back with her hips turned outward and her hips turned outward and her knees slightly bent.
When pressing on the pubic symphysis, both from the front and from the vagina, severe pain is determined. In addition, you can determine the discrepancy itself - the fingertip is placed in it. A significant discrepancy of the symphysis pubis (more than 2 cm) is also indicated by the appearance of a waddling, duck-like gait.
The diagnosis is clarified by x-ray and ultrasound diagnostics. During pregnancy, preference is given to ultrasound diagnostics, considering harmful influence X-rays to the fetus. Typically, an X-ray of the pelvis reveals discrepancy of the symphysis pubis of varying degrees, but there are no pathological changes in the bones.
When determining the concentration of calcium and magnesium in the blood and urine, their amount in the blood decreases by almost half, and their content in the urine is slightly increased. Only by determining the content of calcium and magnesium in the blood and urine of a pregnant woman in the absence of complaints can one predict the divergence of the symphysis pubis.
The course of symphysiopathy is usually favorable. This disease in itself during pregnancy is not an indication for delivery through surgery. caesarean section- neither planned nor emergency. To determine obstetric tactics In choosing a method of delivery, the size of the divergence of the symphysis pubis is important.
If there is pronounced divergence of the symphysis during pregnancy and there is a risk of trauma to the pelvic bone during childbirth, delivery is performed by cesarean section. When the pelvis is narrowed and relatively large size For a fetus with a voluminous, dense head, the critical divergence distance should be considered 10 mm.
Rupture of the symphysis. This severe form of symphysis injury is rare. It is characterized by a violation of the integrity of the joint, is most often associated with childbirth and occurs when the divergence of the symphysis pubis of the third degree is more than 2 cm. Rupture of the symphysis pubis with damage to the ligaments is often combined with damage to one or both sacroiliac joints and usually occurs during childbirth with surgical delivery (obstetric forceps) or when a narrowed pelvis is combined with violent labor.
On my own mechanical injury does not have a dominant value: the tensile strength of the pubic symphysis is on average 200 kg. The changes associated with symphysiopathy, as well as the previous ones, are of primary importance. inflammatory changes in the pubic bones and pubic symphysis, and even a slight mechanical impact is an impetus for the rupture of the weak adhesion of the ligamentous apparatus.
In most cases, during childbirth there is a slow spreading of the tissues of the symphysis pubis, so complaints of pain in the pubic area, aggravated by moving the legs, appear a few hours later or on the 2nd -3rd day after birth. Only in in rare cases the woman in labor feels sharp pain in the area of ​​the womb, sometimes a characteristic sound of tearing ligaments is heard, after which even the large head of the fetus quickly descends through the expanded bone ring.
Rupture of the pubic symphysis is sometimes accompanied by injury to the bladder and urethra, the formation of hematomas in the pubic area and labia, and the addition of an inflammatory process - symphysitis.
The postpartum woman cannot raise her legs (symptom of “stuck heel”) and turn on her side; in bed she takes a forced position (“frog pose”). On palpation both from the front and from the side of the vagina, severe pain is determined and, in addition, mobility of the pubic bones and retraction due to their wide distance from each other.
The nature of the damage is clarified when x-ray examination. A rupture of the symphysis pubis is indicated by: divergence of the pubic bones up to 7-8 cm,
the presence of a vertical displacement of the horizontal branch of the bone by 4 mm or more.
Without special treatment symphyseal ligaments do not fuse or are connected by scar tissue, forming false joint, therefore, when walking, both halves of the pelvis subsequently make rocking movements, a “duck walk” appears, and constant complaints of lumbosacral pain are regarded as radiculitis.
In severe cases of damage to the symphysis pubis (rupture, severe sprain), as well as in the absence of effect from conservative treatment are usually used surgical treatment using metal structures, applying lavsan and wire sutures. Working capacity is restored 3-4 months after surgery.
Symphysitis. This term refers to changes in the pubic symphysis caused by an inflammatory process. Symphysitis is characterized by the fact that in the presence or absence of a pronounced divergence of the pubic bones, the disease is accompanied by a characteristic inflammatory reaction: pain, impaired movement in the limbs, swelling and redness in the pubic area, and a feverish state. The x-ray shows the discrepancy of the symphysis pubis with the phenomena of osteoporosis (rarefaction) in the bone tissue.
Chronic inflammatory processes V bladder(cystitis) and urethra(urethritis) may be accompanied by focal changes in the symphysis pubis. The disease develops when there is chronic infection in the genitourinary tract (ureaplasma, mycoplasma, herpetic infection, staphylococcus carriage) in pregnant and postpartum women against the background of calcium and magnesium deficiency, with hypovitaminosis D. The use of antibacterial therapy in combination with calcium and magnesium preparations, UV irradiation gives excellent and rapid therapeutic effect even with severe course symphysitis with pronounced divergence of the symphysis pubis.
For the prevention of symphysiopathy and other injuries of the symphysis pubis, the following are important:

1. A diet rich in minerals and trace elements involved in the formation of the skeleton (calcium, phosphorus, magnesium, zinc, manganese), as well as rich in vitamin D: milk, lactic acid products, yoghurts, low-fat cheeses, eggs (yolk), meat and liver of mammals and birds, meat fatty fish, fish liver, caviar, seafood, as well as legumes, mushrooms, herbs, nuts.
2. Sufficient physical activity during pregnancy, visiting schools for expectant mothers where it is used therapeutic exercises to strengthen the muscles of the back, abdomen, buttocks and stretch the pelvic floor ligaments.
3. Long stay fresh air. Under the influence ultraviolet rays sunlight Vitamin D is produced in the skin.
4. Taking multivitamins for pregnant women, biologically active additives with trace elements and antioxidants.
5. For poor absorption of calcium associated with gastrointestinal disease, take digestive enzymes, fight against dysbiosis.

Treatment of symphysiopathy
If the pubic symphysis diverges during pregnancy and childbirth, as a rule, surgery can be avoided.
In the case of the development of symphysiopathy with a slight divergence of the symphysis pubis during pregnancy or after childbirth, it is recommended to limit physical activity, wear a bandage, sleep on an orthopedic mattress, take calcium supplements in a well-absorbed form (CALCIUM CARBONATE, L ACT AT CALCIUM), CaDs NYCOMED, ​​FISH OIL (better in capsules), MAGNE Be, B vitamins, UV irradiation. In the presence of a urogenital infection, it is prescribed antibacterial therapy taking into account sensitivity to antibiotics. It is also recommended to use painkillers in the form of gels, ointments or suppositories and tablets.
With II and III degrees of divergence of the pubic bones in the postpartum period, the main thing is to bring the ends of the pubic bones closer together and hold the pelvic bones in a certain position. This is achieved by bed rest (you cannot get up or walk for 2 to 6 weeks after birth), as well as by using a bandage or tight bandage. On the first day after birth, cold is used, and subsequently physiotherapeutic procedures are used on the area of ​​the symphysis pubis. Calcium supplements and painkillers are used; if inflammation occurs (symphysitis), antibacterial therapy and a diet with increased content calcium.
After the expiration of the period, X-ray control is carried out, after which the woman begins to wear a bandage.
Currently, special corsets are used that help hold the pelvic bones in a certain position, which allows for extended bed rest. Usually within 3-5 days bed rest wearing a corset, a woman can already get up and care for her child. The corset is worn from 3 to 6 months.
In order to facilitate childbirth, eliminate the existing obstacle to the passage of the fetus, especially the head through the bone ring in the presence of pelvic narrowing, from ancient times to the present in some countries of Africa and Latin America They use a pelvic dilatation operation - symphysiotomy (dissection of the symphysis).

Pain syndrome in the pelvic area after pregnancy experienced by more than half of women. This symptom may indicate serious problems, so you not only cannot ignore it, but you also cannot delay a visit to the doctor. A specialist who deals with such problems is a vertebrologist.

You can seek help from Dr. Ignatiev’s Clinic in Kyiv to receive comprehensive consultation, examination and treatment from experienced and highly qualified vertebrologists. Reception of a specialist is carried out by appointment.

Current statistics are disappointing. Painful sensations in the pelvic bones are experienced not only by women with a predisposition to diseases of the spine and musculo-ligamentous apparatus, but also by healthy women. The thing is that modern girls lead a passive lifestyle, do not play sports, work in sedentary jobs and are underpaid. useful substances from food. All this leads to the fact that their body weakens, including the weakening of the pelvic bones.

• Displacement of the pelvic bones during and after childbirth. The bones of the pelvis, as well as the coccyx, shift, moving apart and making room for the fetus during childbirth. This helps the baby to be born, but also rewards the woman with severe pain during the postpartum period. The displacement of bones occurs almost painlessly, but returning them to their original position brings a lot of pain and suffering.
• Lack of calcium - affects in such a way that during overload during pregnancy, calcium is washed out, and after childbirth, its reserves are depleted. This leads to the fact that the recovery process in a woman’s body cannot proceed according to the planned pattern, since the body simply does not have enough resources.
• Overstrain, sprained muscles and ligaments. This happens during pregnancy, and after childbirth, the stretched ligaments cannot fully perform their functions, so they are taken over by bones that are not intended for this purpose. As a result, pain appears.
• Softening of tissues - this process occurs as a result of an increase in the concentration of a hormone that calms a woman during childbirth. The tissues no longer perform their functions, so the pelvic bones bear an even greater load.
• Birth trauma - dislocation or fracture of the pelvic bones can occur during childbirth. And if the woman was under anesthesia, then the consequences of the fracture can only be revealed after a while. This leads to severe pain and may even affect bone malunion.

Diagnosis of pregnant women with pelvic pain. Clinic of Doctor Ignatiev

Depending on the cause of the pain, the latter may wear different character. Stretching or overstraining of muscles results in a dull and nagging pain that may continue long period time, around the clock, intensifying during sleep. A lack of calcium also leads to pain, but it is noticeable during exercise or uncharacteristic movements, for example, during exercise or aerobics. More serious reasons– injury or softening of tissues – accompanied by strong and acute attacks pain that cannot be relieved at home.

In order to start treatment in a timely manner, it is necessary to determine the cause pain in the pelvic area. Differentiated diagnostics allows you to detect the root cause by comparing symptoms and research results with possible diagnoses. She will rule out diseases internal organs or birth trauma allowing you to focus on the root cause pain syndrome.

After the diagnosis is made, the clinic’s specialists begin immediate treatment, the purpose of which is to eliminate the cause of the pain. In addition, pain relief occurs in parallel. The main methods of treatment are manual therapy methods. They are effective in most cases. Only a severely neglected condition may require surgical intervention. If the patient sought help at the first symptoms, manual techniques will relieve her of pain.